Hi Beth, my best wishes and high hopes for good results in the surgery for SCS.
Di

nerve compression syndromes
Repeated or prolonged pressure on a nerve root or peripheral nerve leading to ischemia, the response to which is oedema above and below the source of pressure. If the pressure is not relieved, fibrosis tends to develop. Types of nerve compression syndromes are the neuropathy caused by intervertebral disk herniation, compression of the median nerve in the carpal tunnel, compression of the ulnar nerve in the elbow, and compression of the lateral cutaneous nerve of the thigh in meralgia paresthetica. This is also called pressure neuropathy.

cicatrix;"new skin forming"(the external scar) But we all know as consumers that this scar is not what we expect in pre or post surgery. That scar matter is from the damaged nerves and soft tissues.

I can guess that many new to TOS may get confused to the term we use in scar matter and fibrous bands, and adhesions.

fibrous adhesion
Fibrous strands resulting from the organization of fibrinous adhesions.
fibrinous
fibrinous adhesion
An adhesion that consists of fine threads of fibrin resulting from an exudate of plasma or lymph, or an extravasation of blood.
(05 Mar 2000)

fibrin
<protein> The insoluble protein formed from fibrinogen by the proteolytic action of thrombin during normal clotting of blood. Fibrin forms the essential portion of the blood clot.
(12 Nov 1997)


connective tissue
<pathology> Rather general term for mesodermally derived tissue that may be more or less specialised. Cartilage and bone are specialised connective tissue, as is blood, but the term is probably better reserved for the less specialised tissue that is rich in extracellular matrix (collagen, proteoglycan etc.) and that surrounds other more highly ordered tissues and organs.


extracellular matrix
Any material produced by cells and secreted into the surrounding medium, but usually applied to the noncellular portion of animal tissues. The ecm of connective tissue is particularly extensive and the properties of the ecm determine the properties of the tissue.

In broad terms there are three major components: fibrous elements particularly collagen, elastin or reticulin), link proteins (e.g. Fibronectin, laminin) and space filling molecules (usually glycosaminoglycans). The matrix may be mineralised to resist compression (as in bone) or dominated by tension resisting fibres (as in tendon). The basal lamina of epithelial cells is another commonly encountered ecm. Although ecm is produced by cells, it has recently become clear that the ecm can influence the behavior of cells quite markedly, an important factor to consider when growing cells in vitro: removing cells from their normal environment can have far reaching effects.
(18 Nov 1997)

Concern is not so much in post op-PT as far as I ever expected from post-op range of motion, but not over doing venerable ill nerves recovering from surgery.PT as range of motion is much different then a regime to work harden as w/c calls it.

Two weeks after surgery from TOS attributed to being a wall painter and consistent compression to a body prone to TOS, would not be smart for a person to go back to wall painting again.....

Post surgery, if you developed TOS from a repetitive job, and go back to the repetitive job, you can expect new damage to re-occur and symptoms to return. Some do some do not...it is historically accepted that it is even with sedentary no work, that a person can develop "scar matter/adhesions /fibrous bands".

De had surgery and there was much scar matter/fibrous bands pulled the scalense and other connective tissue into odd places causing compressions. For example, the scalene are attached to the collar bone by bands in a manner...almost 1/2 of society has these smaller bands. BUT for the injury or assault, TOS can occur.

One of these short bands caught up a tissue and pulled it from the collar bone to the arm pit area in a "Spasm" (located during the arm pit portion of surgery). Dr T located and released it and the band snaked up into the body. When he reached the part of the surgery from the collar bone area; at that time he removed the "band" that had formed and measured it at 1 1/2 inch long....streching all the way to the armpit OUCH!

So it was hoped a lot of symptoms would be resolved. BUT, this band had been a problem for years prior to surgery and created restrictions, compressions and nearby tissues and nerves were affected.

During her second surgery, fibrous bands were found entwined among the C3-4-5-6-7 nerves entangling them.

Damaged tissue and blood lying in the area from the first surgery, even though a drain was used collected and did not, does not dissolve. Dead tissue or matter attaches to any nearby structure including the nerves.

The entanglement was clean-up and nerves were wrapped in pericardial patch-gortex. It was hoped that the covering prevented new growth attachment of matter.

But, it seems to have grown over the coverings and entwined.
Redo's I jokingly tell her that she was roto-rooter to clean up. There was improvement, BUT as early as two months scaring, adhesions, fibrous strands or bands can form.
Dianne